Supreme Court Ruling: Implications for the Field of Health Promotion

Tracey Moorhead President & Chief Executive Officer

Care Continuum Alliance www.carecontinuum.org

Presented by:

Thursday, July 12, 2012

Paul E. Terry, Ph.D. Chief Executive Officer

StayWell Health Management www.staywell.com

The voice of wellness, prevention and chronic care management

Supreme Court Ruling: Implications for the Field of Health Promotion

Tracey Moorhead, President & Chief Executive Officer Care Continuum Alliance www.carecontinuum.org

The Continuum of Care

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SCOTUS: Implications for Employers

• PPACA Implementation ramp up • Employer-related regulations expected in

coming months: • Employer play or pay • Full-time employee methodology • Exchange Operations • Auto-enrollment • Increase in Wellness Incentives

PPACA: Prevention and Wellness

Employers • Codifies premium discounts, cost-sharing waivers and other

employee rewards up to 30 percent of the cost of coverage • HHS can increase reward percentage to 50 percent.

• Authorizes $200 million in grants over five years for small business workplace wellness programs.

• Establishes a 10-state pilot by July 2014 to apply similar rewards for participating in wellness programs in the individual market.

• Requires report on the effectiveness and impact of wellness programs due three years after enactment – Care Continuum Alliance supporting RAND in report development.

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SCOTUS: How will Health Plans Respond?

• Plans will likely offer strategies focused on:

Cost management, limiting care to a narrow network of providers or price controls

Care management, requiring or incenting covered members to utilize health coaching or care/disease management

Enhanced customer service

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"Supreme Court Ruling:

Implications for the Field of Health Promotion"

Paul E. Terry, Ph.D., Chief Executive Officer

StayWell Health Management

www.staywell.com

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2009 Emerging

Healthcare Trends

Leadership Award

Our mission & vision

2

Koop Award

Winners

2011

Cummins

2010

Volvo

2009

Alliance Data

2008

Wachovia

2007 Pepsi

Bottling Group

2006 Roche, Inc.

2003 Fairview Health

2002

HMSA

2001

Northeast

Utilities

2000

Caterpillar CIGNA

DaimlerChrysler

1998

Applied Materials Chevron

1997

Motorola

1995

CIGNA

1994

Quaker

Our mission

To help people achieve optimal health through solutions

that set the standard for quality, effectiveness and value.

Our commitment to our clients

We partner to ensure high levels of satisfaction and deliver successful

results defined by our clients and the industry.

Our commitment to the industry

We will lead research to define best practices, innovate in search of

excellence, publish outcomes to inform the industry and drive

standardization.

Our impact

StayWell enjoys unparalleled long-term relationships with our clients, who

have received industry recognition for their programs.

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Chief Roberts:

“Put simply, Congress may tax and spend.”

Something for every

Ideology

Individual

Responsibility for

Health: Employee

Engagement

Social Responsibility

for Health: A Culture

of Health

Not a mandate,

but a tax.

• No more “free

riders.”

• HIPAA Incentives for

achieving a standard.

• Less employer

based coverage?

(CBO: 20 million fewer

covered by 2019.)

• No lifetime limits on

coverage.

• No pre-existing

conditions denials.

• No premiums based

on risk. (Higher

premiums for young,

healthy.)

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Paul Terry and John Horton

1973, 2010

Richard Nixon: Health Maintenance

Organization Act, 1973

Barack Obama: Affordable Care Act, 2010

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Beating Butter: Denmark Imposes the World's First Fat Tax

The tax, the first of its kind in the world, imposes a 16 krone (roughly $3) hike per kilo of saturated fat on

any food that contains more than 2.3%.

"At the political level there was a high degree of consensus for this law," says Tor Christensen, chief

consultant for Denmark's Ministry of Taxation.

It's just going to push more people to buy cheaper industrially produced products, rather than good food.

It's insanely stupid. Christian Puglisi, chef of Copenhagen's highly-regarded Relae

By LISA ABEND

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Health Policy

Progress Technical, historical, incremental

1973-2012

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Effects of Risk Factors on

Monthly Resource Use

Variable At Risk Not at

Risk

Sign

Level Smokers $255 $258 NS

Excess Alcohol $188 $291 NS

Obesity $326 $264 .05

Physical Inactivity $358 $238 .0001

Unhappiness

$424

$253

.0001

Terry, Am J Health Promot, May 1998

(Seniors 65 and Older)

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Adherence to Quality Indicators

56% 55% 18.3%

Recommended

Care Recommended

Chronic Care

Recommended

Preventive Care

Counseling/Education

Source: N Engl J Med 2003; 349:1866-1868 November 6, 2003

55%

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Effective Programs Drive Positive Outcomes

Grossmeier, J., Terry, P.E., Anderson, D., Wright, S., “The Financial Impact of Population

Health Management Programs, Reevaluating the Literature.” Population Health Management.

Vol. 15, No. 3, 2012. June 2012: P. 129-134.

Terry, P.E., Seaverson, E., Staufacker, M.J., Tanaka, A., “The Effectiveness of a Telephone-Based

Tobacco Cessation Program Offered as Part of a Worksite Health Promotion Program.”

Population Health Management. Dec. 2010, Volume 14, Issue 7, 2011.

Terry, P.E., Seaverson, E., Grossmeier, J., Anderson, D. "Effectiveness of a Worksite Telephone-

Based Weight Management Program." American Journal of Health Promotion. January/February

2011, Vol. 25, No. 3. Pp. 186-189.

Grossmeier, J., Terry, P.E., Cipriotti, A., Burtaine, J., “Best Practices in Evaluating Worksite Health

Promotion Programs” American Journal of Health Promotion: Vol. 24, No.3, TAHP1-9.2010

Terry, P.E., Xi, M., "An Examination of Presenteeism Measures: The Association of Three Scoring

Methods with Health, Work Life and Consumer Activation" Population Health Management. Dec.

2010, Volume 13, Issue 6.

Terry, P.E., Seaverson E.L., Staufacker M., Gingerich, S.; A Comparison of the Effectiveness of a

Telephone Coaching Program and a Mail-Based Program, Health Education and Behavior.

October 27, 2010.1177

Terry, P.E., Fowles, J., Harvey, L., "Employee engagement factors that affect enrollment

compared with retention in two coaching programs-The ACTIVATE Study" Population Health

Management. DOI: 10. 1089, Vol. 13, No. 3, 2010. P.115-122.

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See additional StayWell research, publications and reports at www.staywell.com.

Incentives for

Participation or

Outcomes

Terry, P.E., Anderson, D. R. (2011).

Finding common ground in the use of

financial incentives for employee

health management: A call for a

progress-based approach.

American Journal of Health

Promotion, Sept. 2011, Vol. 26, No. 1,

ev-evii.